Most Malaysian ED patients wait for an average of four years before consulting doctor

The Head of the Urology Unit at Universiti Kebangsaan Malaysia's Medical Faculty was referring to men's hesitation in addressing their erectile dysfunction (ED) problem where consulting the doctors are often their last resort.

However, for medical experts like Dr Zulkifli the ED issue needs urgent attention as is not just about ED.

"Often ED is associated with other diseases like diabetes and cardiovascular diseases. ED is a sign that something is wrong with your body," he explained.

ED is the inability to attain and or maintain sufficient penile erection for satisfactory sexual intercourse. ED is on the rise, affecting one in five Malaysian men.

However, those with ED are known to dilly-dally with Dr Zulkifli revealing most ED patients would wait for an average of four years before consulting a doctor.

Because of the embarrassment and social stigma many would rather hush up about their condition, with some even concealing the problem from their spouses.

"They look for solutions online or try something unconventional that their friends suggest like seeing a 'bomoh' (shaman), go for 'urut batin' (traditional massage) or apply gambir Sarawak (astringent extract) or take Tongkat Ali (aphrodisiac) or injecting silicone, a popular option nowadays.

"Now with the internet, it is so much easier for these men to communicate incognito in seeking remedy but not all of the remedies are safe or proven to work," said Dr Zulkifli adding that he had carried out countless surgeries on damaged male external genitalia due to the wrong remedies.

"I can vouch that all these things - Urut batin, Tongkat Ali, silicon injection - not only do not work but they are also hazardous.

"In some cases this remedies have caused permanent damage. What used to be a condition that can actually be helped with medication now is a lost cause," he pointed out.

ED IS NOT THE END

Zulkifli said men who suspected that they suffered ED should undergo medical check up to find out the real causes of their condition.

"Based from the check up we can identify in which stage the ED patients are in, ranging from stage one to stage four.

"For stage one and two a low dose medication in the form of pills is commonly prescribed that would enable the patient to have sex within four hours.

"If pills does not work, patients of stage three and four could opt for other treatment such as drug injection or operation of installing vacuum pump or penal rod," he said.

However, many of the affected men appear unconvinced or too shy and hence Dr Zulkifli is also perplexed on how to reach out to men with ED so that they will consider getting proper treatment and free themselves from their misery.

Dr Zulkifli himself has tried to make it as convenient as possible for these men to come to his clinic including by ensuring that the clinic operated at lunch hour and all staff were male.

"They can just call the clinic to make an appointment, there is no need for a referral letter.

"And we have done many awareness campaigns, talked to reporters, did write-ups, but the outcome is the same, men with ED shy away from the right treatment," he said in disappointment.

ED MEDICATION USERS HAVE SATISFACTORY SEXUAL LIFE

Unlike twenty to thirty years ago when impotence was viewed as the end of the road for men when comes to sex life, with modern medication those afflicted with ED can enjoy a satisfactory sex life.

The Pfizer Global Sexual Habits 2015 Survey in seven countries - Brazil, China, Italy, Japan, Russia, Taiwan and Turkey - discovered that ED medication users have sexual intercourse six times a month on the average.

Hence, there is a new lease of life for those men with ED and there is no reason for any gentlemen to delay or shy away from seeking treatment from the right people.

DEPRESSION AND ED

Erectile Dysfunction (ED) is also linked to psychological factors between 10 to 20 per cent of the ED cases.

Depression and stress are among the common causes of ED, besides anxiety, low self-esteem, guilt and indifference, which usually originates from marital problems or prior ED episodes.

Consultant Urological Surgeon at the Gleneagles Hospital Kuala Lumpur Professor Dr George Lee Eng Geap said modern lifestyle, especially work and career, contributes stress among couples thus affecting their relationship as well as sexual habits.

He insisted that doctors have the best resources for helping a person lead a healthy sex life.

"If you feel your sex life is suffering because of emotional, mental and or other psychological reasons, your doctor can also help you or refer you to a more appropriate professional, such as therapist or sexologist," he said.

He pointed out that most men at one time or another would experience ED.

"Only if the problem reaches a point where the couple cannot maintain their relationship, or it creates tension within the relationship, that is when we doctors actually intervene.

"For men whose ED is caused by psychological problems, counselling therapy may be needed," said Dr Lee.